The Long-Term Care Quality Initiative uses research evidence to improve the wellbeing of residents, families and staff across BC.
Sitting in front of a TV all day isn’t what we envision for our loved ones in long-term care. Without social connections and strong support, long-term care can be lonely and isolating for many residents.
A provincial initiative is making sure this isn’t the case. The Long-Term Care Quality Initiative uses research evidence to improve the wellbeing of residents, families and staff. Michael Smith Health Research BC (Health Research BC), the Ministry of Health, and regional health authorities worked together to advance this new approach. Key to the initiative was the INFORM (Improving Nursing Care through Feedback on PerfoRMance Date) model health authorities used to assist long-term care homes make lasting changes.
The INFORM model supports care managers to make changes and improve performance by working on modifiable elements within their care units. It is also adaptable to other improvement targets.
Informed by survey results collected by the Office of the Seniors Advocate, 31 care home teams selected change ideas. Most focused change goals on resident life stories and meaningful activities. Each health authority saw positive impacts. Learn more about the impacts below.
For long-term care homes throughout the province, BC INFORM provided an important lens on how to sustain and create positive change — requiring full participation of managers, staff, residents and families. Success for many long-term care homes meant including residents and family members as part of project teams. Ninety percent of residents and family members who responded to a survey about BC INFORM in their homes felt they were being heard and that the projects would make a long-term difference.
BC INFORM proved its value. Projects allowed staff to stop and re-think the ‘why’ of long-term care — recognizing that connecting with residents on a personal level is as important as clinical care. Long-term care isn’t only about providing care. It’s about making the place a home. And that is rooted in wellbeing.
Update: Learnings from the LTC-QI project are informing the Long-Term Care Quality Framework, announced by the BC government in 2024. The Regional Practice Lead positions, integral to the work of LTC-QI, are embedded in the regional health authorities with a focus on quality improvement in long-term care.
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Impacts of the INFORM model
Minoru Residence in Richmond is an example of storytelling in action.
“The life stories [we had] weren’t always complete, or they were in a resident’s chart where only specific staff had access,” says Jasjit Gill, operations initiative lead at Minoru. “Staff felt they didn’t have enough details about a resident’s life story when they needed them.”
Through BC INFORM, Minoru created ways to share important aspects of a resident’s life story. These included staff emails containing photos and stories that were shared when residents arrived or left. A TV in the dining area displayed photos, art and phrases about residents. As a ‘memory box,’ it was updated with information the residents wished to share. Memory boxes also provided: person-centred care tips for mealtime; communication strategies dealing with age progression; and suggestions for enhancing quality of life and interactions for people in care and their caregivers.
“It’s important for staff, residents, administrators and others to know the residents and their life stories, so they know how to best approach day-to-day interactions for persons in care,” says Monica Lee, regional practice lead for Vancouver Coastal Health.
Minoru Residence in Richmond is an example of storytelling in action.
“The life stories [we had] weren’t always complete, or they were in a resident’s chart where only specific staff had access,” says Jasjit Gill, operations initiative lead at Minoru. “Staff felt they didn’t have enough details about a resident’s life story when they needed them.”
Through BC INFORM, Minoru created ways to share important aspects of a resident’s life story. These included staff emails containing photos and stories that were shared when residents arrived or left. A TV in the dining area displayed photos, art and phrases about residents. As a ‘memory box,’ it was updated with information the residents wished to share. Memory boxes also provided: person-centred care tips for mealtime; communication strategies dealing with age progression; and suggestions for enhancing quality of life and interactions for people in care and their caregivers.
“It’s important for staff, residents, administrators and others to know the residents and their life stories, so they know how to best approach day-to-day interactions for persons in care,” says Monica Lee, regional practice lead for Vancouver Coastal Health.
Acropolis Manor in Prince Rupert introduced weekend activities that brought energy and joy back into residents’ lives.
“We created a new rotation for recreation therapy staff that included weekend activities, such as balloon volleyball, arts and crafts, baking and sitting outside in the courtyard on sunny days listening to music,” says Marcie Garinger, manager at Acropolis. “Residents were highly engaged and both recreation staff and families saw the value. Frontline staff are the ones who see where opportunities for improvement are. Trusting them to make those improvements, empowers them, increases their job satisfaction, and enhances relationships with their colleagues, residents and families.”
Residents at Acropolis Manor in Prince Rupert enjoy new weekend activities.
Care homes across Northern Health saw similar success. “It was fantastic to see the teams come together and achieve their goals,” says Matthew Fagan, regional practice lead.
Leslie Godwin, general operations manager at David Lloyd Jones Home in Kelowna took a multidisciplinary approach to improving the quality of food service. Staff, residents and families all provided input. As a result, the home now offers high-quality snacks throughout the day to promote better nutrition and increased socialization. Behind the scenes, the project improved communication between food services and operations at the regional level as well. Thanks to this collaboration, the specific needs of each long-term care home are now the focus, rather than a standardized food service across the region.
Michelle Smith, regional practice lead for Interior Health, says the process strengthened relationships between staff and residents. “BC INFORM provided a shared priority to improve quality of life, care and service for people living in long-term care, engagement with their families, and quality of work life for staff.”
Thanks to the BC INFORM process, Eagle Ridge Manor in Port Hardy saw its existing falls prevention program, Bingocize, turn into much more.
“We noticed a significant reduction in the number of falls during the implementation period,” says Cindy Perry, manager of Eagle Ridge. “But we observed other things as well. Some residents were smiling more and encouraging other residents to join in.”
The care home added more staff and volunteers to the game to sit with residents and encourage social engagement. The Bingocize’s evaluation tool saw a 23% increase in resident engagement and fun. Staff were also more engaged, doing exercises and even dancing with residents.
“Many projects across the health authority illustrated how strong relationships greatly improve life for residents in long-term care, especially in small rural communities where human resources can be especially difficult,” says Amanda Leddy, regional practice lead for Island Health.
